Relationship between Central Venous-arterial Carbon Dioxide Difference and Postoperative Cognitive Dysfunction in Patients with Acute Aortic Dissection
WANG Lei
JIANG Zhang
ZHANG Wenxiu
DING Lili
YANG Ting
XIAO Liqiong
Abstract：Objective: To explore the relationship between central venous-arterial carbon dioxide partial pressure difference (Pcv-aCO2) and postoperative cognitive dysfunction in patients with acute aortic dissection. Methods: A retrospective analysis was conducted on the general data of 472 patients with acute aortic dissection who underwent surgery at the Department of Cardiothoracic Surgery, Nanjing First Hospital from January 2018 to December 2021. Venous and arterial blood samples were collected before cardiopulmonary bypass (CPB), 30 minutes after CPB, before deep hypothermic circulatory arrest, after deep hypothermic circulatory arrest, half an hour after rewarming, and 5 minutes before weaning from CPB for blood gas analysis, and Pcv-aCO2 values were calculated. Patients were divided into an observation group (Pcv-aCO2 > 6 mmHg, 224 cases) and a control group (Pcv-aCO2 < 6 mmHg, 248 cases). The incidence of postoperative cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE). The perioperative data and serum levels of S100β and neuron-specific enolase (NSE) in peripheral blood 6 hours postoperatively were analyzed. Results: The incidence of postoperative cognitive dysfunction was higher in the observation group than in the control group (16.96% vs. 9.68%, P < 0.05). Serum levels of S100β and NSE were higher in the observation group than in the control group (P < 0.05). There were statistically significant differences in preoperative carotid plaque, duration of deep hypothermic circulatory arrest, and CPB time between patients who developed cognitive dysfunction in both groups (P < 0.05). Conclusion: An increase in Pcv-aCO2 during surgery is associated with the occurrence of postoperative cognitive dysfunction in patients with acute aortic dissection and can serve as an intraoperative early warning indicator for cognitive dysfunction.
Keywords：acute aortic dissectioncognitive dysfunctionvenous-arterial carbon dioxide partial pressure difference
Publication Date：2025-02-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 422-426 )